Gideroğlu Kaan, Toksoy Serdar, Akan Mithat, Yildirim Serkan, Sümbüloğlu Emin, Aköz Tayfun
Department of Plastic and Reconstructive Surgery, Medicine Faculty of Abant Izzet Baysal University, Bolu, Turkey.
Eklem Hastalik Cerrahisi. 2009;20(2):107-13.
Clinically, the Z-plasty lengthening is the only method used in the upper extremity, whereas several different techniques such as the Vulpius and Baker are used in the lower extremity. In this study, the usage of the modified Vulpius and Baker tendon lengthening techniques in the upper extremity was investigated.
Vulpius and Baker techniques are modified by changing their application site in 90 sheep fore-limb deep flexor tendons using three randomly divided groups. Z-plasty, V-Y-plasty (Modified Vulpius) and U-T-plasty (Modified Baker) techniques were used in groups I to III, respectively. Their elongation and biomechanical properties were compared.
The Z-plasty technique provided significantly greater lengthening than the other two techniques, followed by the U-T-plasty technique. Failure load of the U-T-plasty technique was 60.7% higher than the Z-plasty technique and 45.4% higher than the V-Y-plasty technique. Repairs with the U-T-plasty and V-Y-plasty techniques were significantly stiffer than the repairs with the Z-plasty technique.
The U-T-plasty technique may be a good alternative to the Z-plasty technique because of its easy application and better biomechanical properties, especially in cases that need moderate-sized elongation and early mobilization. But the restorative properties of this technique need to be observed on an in-vivo model.
临床上，Z形皮瓣延长术是上肢使用的唯一方法，而下肢则使用几种不同的技术，如Vulpius和Baker技术。在本研究中，对改良的Vulpius和Baker肌腱延长技术在上肢的应用进行了研究。
通过将90只绵羊前肢深屈肌腱的应用部位进行改变，对Vulpius和Baker技术进行改良，分为三个随机分组。分别在I组至III组中使用Z形皮瓣、V-Y形皮瓣（改良Vulpius）和U-T形皮瓣（改良Baker）技术。比较它们的伸长和生物力学性能。
Z形皮瓣技术提供的延长明显大于其他两种技术，其次是U-T形皮瓣技术。U-T形皮瓣技术的破坏载荷比Z形皮瓣技术高60.7%，比V-Y形皮瓣技术高45.4%。使用U-T形皮瓣和V-Y形皮瓣技术修复的刚度明显高于使用Z形皮瓣技术修复的刚度。
U-T形皮瓣技术可能是Z形皮瓣技术的一个良好替代方案，因为它应用简便且生物力学性能更好，特别是在需要适度延长和早期活动的情况下。但该技术的修复特性需要在体内模型上进行观察。
